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Prior research on students with mathematical learning disabilities (MLDs) focuses on identifying performance deficits and designing interventions to remedy those deficits. This study presents an alternative perspective grounded in a Vygotskian theoretical frame. From this perspective, mathematics is understood to be a mediated activity and disability is understood to result in the inaccessibility of some mediational tools. Re-mediation, therefore, involves the design of alternative accessible mediational tools. In this study, a re-mediation approach was designed based on a detailed analysis of a student with an MLD. Videotaped re-mediation sessions were analyzed to trace how the student appropriated this novel mediational tool. This paper is a proof-of-concept for reconceptualizing re-mediation and provides an alternative to the dominant deficit discourse.